60RRBH21R0011 Attachment J.7 Basis of Estimate.xlsx

XLSX spreadsheet 113 KB Posted

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Solicitation 60RRBH21R0011 - RRB Specialty MAC
Solicitation number
60RRBH21R0011
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60RRBH21R0011 Attachment J.1.C Performance Requirements Summary -Revised.docx DOCX document
60RRBH21R0011 Amendment 0002.pdf PDF
60RRBH21R0011 Attachment J.13 CLIN 0004 Cost Proposal Template Option Year Two- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.16 CLIN 0007 Cost Proposal Template Option Year Five- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 RRB SMAC Services- Amendment 0001 Q and A and other changes SF 30.pdf PDF
60RRBH21R0011 Attachment J.7 Basis of Estimate- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.1.C Performance Requirements Summary.docx DOCX document
60RRBH21R0011 Attachment J.14 CLIN 0005 Cost Proposal Template Option Year Three- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.18 CLIN 0009 Cost Proposal Template Option Year Seven- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.15 CLIN 0006 Cost Proposal Template Option Year Four- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.11 CLIN 0002 Cost Proposal Template Base Year- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.33 RRB SMAC Providers by State.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.20 CLIN 0011 Cost Proposal Template Option Year Nine- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.12 CLIN 0003 Cost Proposal Template Option Year One- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.17 CLIN 0008 Cost Proposal Template Option Year Six- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.34 RRB Responses to Offeror Questions.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.19 CLIN 0010 Cost Proposal Template Option Year Eight- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.1 RRB SMAC SOW- Revised.docx DOCX document
60RRBH21R0011 Attachment J.14 CLIN 0005 Cost Proposal Template Opt Year 3.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.17 CLIN 0008 Cost Proposal Template Opt Year 6.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.18 CLIN 0009 Cost Proposal Template Opt Year 7.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.10 CLIN 0001 Cost Proposal Template- Implementation Services for RRB SMAC.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.21 CLIN 0012 Cost Proposal Template Closeout.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.16 CLIN 0007 Cost Proposal Template Opt Year 5.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.13 CLIN 0004 Cost Proposal Template Opt Year2.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.15 CLIN 0006 Cost Proposal Template Opt Year 4.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.20 CLIN 0011 Cost Proposal Template Opt Year 9.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.19 CLIN 0010 Cost Proposal Template Opt Year 8.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.3 Small Business Subcontracting Plan.docx DOCX document
60RRBH21R0011 Attachment J.8 Past Performance Questionnaire.doc DOC document
60RRBH21R0011 Attachment J.27 Compliance Attestation.docx DOCX document
60RRBH21R0011 Attachment J.23 Non-Disclosure Statement.docx DOCX document
60RRBH21R0011 Attachment J.11 CLIN 0002 Cost Proposal Template Base Year.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.29 Contractor Furnished Property.docx DOCX document
60RRBH21R0011 Attachment J.2 RRB SMAC Deliverable Schedule.docx DOCX document
60RRBH21R0011 Attachment J.25 Information Security Attestation.docx DOCX document
60RRBH21R0011 Attachment J.1.A Fee-For-Service Shared System Base Functions.docx DOCX document
60RRBH21R0011 Attachment J.4 Billing Instructions.docx DOCX document
60RRBH21R0011 Attachment J.6 Award Fee Plan Template.docx DOCX document
60RRBH21R0011 Attachment J.30 CMS Sec and Priv Language for Info Tech Procurements.docx DOCX document
60RRBH21R0011 Attachment J.28 HHS Contracting Guide for Contract of Government Property.docx DOCX document
60RRBH21R0011 Attachment J.1.B SOW Appendices.docx DOCX document
60RRBH21R0011 Attachment J.32 Cash Collections Worksheet.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.12 CLIN 0003 Cost Proposal Template Opt Year1.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.24 Proposal Assumptions Template.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.10A Cost Template Summary Sheet RRB SMAC.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.31 Systems of Records.docx DOCX document
60RRBH21R0011 Attachment J.10B CLIN 0001 Cost Proposal Template- Implementation Services for RRB SMAC.xlsx XLSX spreadsheet
60RRBH21R0011-Sections B-M.docx DOCX document
60RRBH21R0011 Attachment J.26 Corporate Experience Attestation.docx DOCX document
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Instructions

RRBSMAC Business Proposal
Basis of Estimate - Template Instructions
To provide RRB and CMS with an understanding of the Offeror's basis of estimate, the Offeror shall complete this template for the Base Year and Option Years 1 through 9 as part of its Volume II submission. RRB is providing instructions to the Offeror for populating this template below. In addition, RRB has provided a sample calculation for the Offeror under the Example Tab.
Column A,
Cost Estimating FactorThe first column of the spreadsheet has the workload categories identified in RFP section L. Note: In instances where Section L describes "provider counts" (i.e., Provider Customer Service), the Offeror shall provide the workload assumptions used in its Proposal based on the number of providers identified in the RFP. The Offeror shall insert a separate row for each workload category under the high-level workload category (shaded in grey) provided in the template.The Offeror shall copy and paste the FTE calculation formula in Column G for each inserted row. Also, the Offeror shall insert its proposed workload (by category) identified in its Medical Review Strategy (Tab F, Volume I) for Automated Reviews under the Medical Review heading. At a minimum, the Offeror shall include the categories identified in this Attachment. However, the Offeror is instructed to insert additional rows for Automated Reviews as necessary based on the categories proposed in its Medical Review Strategy. The Offeror shall copy and paste any formulas in the worksheet for each inserted row.
Column B,
Annual WorkloadThe Offeror shall identify the RFP workloads for each cost estimating factor subheading in either light blue or grey (see the example provided in Red under the Base Year Tab). The Offeror shall also provide the annual workload for each workload category using Column B. The annual workload represents the portion of the total functional workload that is projected to be impacted by the specific labor category in Column B (Position / Labor Category). For example, if Claims Analyst I performs some function in handling all paper claims, the workload touched by this position would equate to the total paper claims volume. However, if Claims Analyst I only handles 75% of paper claims, with 25% handled by a Claims Analyst II, this would be reflected in a workload number 75% of that quoted in the RFP Section L. Any workloads listed must tie back to those identified in Section L of the RFP. NOTE: A formula is provided in the template to calculate the workload for each labor category following each sub-heading shaded light blue or grey. However, the Offeror shall ensure that the formula is updated to reflect any new/inserted rows.
Column C,
% Workload Processed with Direct LaborFor each workload category identified in Column A, the Offeror shall identify in Column C the percentage of the annual workload (Column B) that will be processed using direct labor.
Column D,
Position/Labor CategoryFor each workload category identified in Column A, the Offeror shall identify in Column D all positions/labor catagories required to meet the functional requirements of the statement of work. Each position/labor category shall be displayed using a separate row. Note: This may require the Offeror to insert additional rows. The Offeror shall copy and paste all formulas in the worksheet for each inserted row. For manager and supervisor positions/labor categories, the Offeror is instructed to adjust formulas as needed and insert the FTEs based its own proposal assumptions.
Column E,
Annual Productive HoursThe Offeror shall provide the annual productive hours for each position/labor category (identified in Column D) using Column E.
Column F,
Daily Production per FTEThe Offeror shall provide the workload that can be accomplished by one (1) FTE in one (1) business day using Column E. For this template, one (1) business day is defined as eight (8) hours. For example, if Claims Analyst I requires an average of 24 minutes to complete the position-specific tasks for a single paper claim, the Daily Production per FTE for this position would be 20 paper claims (2.5 claims per hour x 8 hours in a day).
Column G,
Total FTEsColumn G contains a formula (in unshaded rows only) to automatically calculated total FTEs for each position/labor category provided by the Offeror. This should reflect the CLIN templates submitted with the Offeror's Business Proposal. Note: For all high-level workload headings (dark blue shading) and sub-headings (light blue or grey), the offeror shall provide a sum of the total FTEs (see example provided under the Base Year tab).
Column H,
% Workload Processed by Indirect Cost CenterWhere applicable, for each workload category identified in Column A, the Offeror shall identify in Column H the percentage of the annual workload (Column B) that will be processed by an Indirect Cost Center.
Column I,
CLIN Template CrosswalkThe Offeror shall provide a crosswalk to the CLIN templates for the FTEs identified for each workload category using Column I.
Column J,
Basis of EstimateThe Offeror shall specify whether the proposed productivity for each labor category is based on its history, or if it is based on a new innovation and/or process improvement proposed for this contract. The Offeror shall also crosswalk any referenced new innovation and/or process improvement in this column to the page, tab, and Volume of its Proposal that contains the narrative describing this innovation/process improvement (e.g., Volume I, Tab G, page 26). In addition, if the basis of the Offeror's proposed productivity is its history, which includes an implemented innovation and/or process improvement referenced in another section of its Proposal, the Offeror shall also crosswalk this to the page, tab, and Volume of its Proposal that contains the applicable narrative to support this implemented innovation and/or process improvement. Note: For the Bills/Claims workload, the Offeror shall notate the Suspence rates used in development of their Bills/Claims productivity estimates for both EMC and Paper claims using the light blue sub-headings (see example provided under the Base Year tab). Offerors shall propose their suspense rate based upon their history and their technical innovations which shall be fully explained in their innovations section.
NOTE: The Offeror shall only provide Attachment J-07 via CD-ROM. The Offeror shall not submit hard copies of this document.

RFP- RRB11R001

Part B Specialty Medicare Administrative Contractor

Attachment J-07 Basis of Estimate Source Selection Information - See FAR 2.101 and 3.104 &P

Example

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Base YearBasis of Estimate - Base Year
Example (Only)
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
Bills/Claims Part B176.24
Bills Claims - EMC6,600,0000.01History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
Bills/Claims - EMC10,5600.16%Claims Analyst I1,864.003,200.000.01All CLIN 0002, SLINAA, SOW D.1.2History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
Bills Claims - Paper900,000176.23New - Paper suspense rate of 9% on new OCR technology (see page 20, Tab E, Volume I)
Bills/Claims - Paper315,00035.00%Claims Analyst I1,864.0020.0050.70All CLIN 0002, SLINAA, SOW D.1.2History - Based on new OCR technology implemented in 2007 (see page 17, Tab E, Volume I)
Bills/Claims - Paper585,00065.00%Claims Analyst II1,864.0015.00125.54All CLIN 0002, SLINAA, SOW D.1.2History - Based on automated process flow implemented in 2006 (see page 17, Tab E, Volume I)

Base Year

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Base YearBasis of Estimate - Base Year
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic4,178,030ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper121,471ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations15,119ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported887ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings22,814ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings81,912ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations4,886ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions393ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions70ERROR:#DIV/0!
Effectuations of ALJ Decisions (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses178ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings173ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries26,630ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries491ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence121,856ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims51,425ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)274,743ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries2,354ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)16ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals6ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions1,821,713ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions1,658,372ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests211ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes109ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes57ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters191ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls43ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews785ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews1,508ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews38,914ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews1,560ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings2,718ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings46ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved36,600ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated232ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG88ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis1,544ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments231ERROR:#DIV/0!
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved1,240ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals18ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries2,429ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

RFP- RRB11R001

Part B SPECIALTY MEDICARE ADMINISTRATIVE CONTRACTOR (RRB SMAC)

Source Selection Information - See FAR 2.101 and 3.104 &P

Option Year One

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year OneBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,356,059ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper242,941ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations30,237ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,773ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings45,627ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings163,823ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations9,771ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions786ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions140ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses356ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings345ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries53,260ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries981ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,849ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings5,435ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings91ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved73,200ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated464ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG176ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis3,087ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer Service Part BERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments461
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved2,480ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals36ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries4,857ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

RFP- RRB11R001

PART B SPECIALTY MEDICARE ADMINISTRATIVE CONTRACTOR (RRB SMAC)

Source Selection Information - See FAR 2.101 and 3.104 &P

Option Year Two

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year TwoBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,357,730ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper242,990ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations30,857ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,809ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings46,562ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings167,181ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations9,971ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions802ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions143ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses364ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings353ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries54,464ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries1,003ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,870ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings5,435ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings91ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved74,854ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated475ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG180ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis3,158ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer Service Part BERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments471
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved2,536ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals37ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries4,857ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

Option Year Three

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year ThreeBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,359,402ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper243,038ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations31,434ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,843ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings47,433ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings170,308ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations10,158ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions817ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions146ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses371ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings359ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries55,460ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries1,022ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,890ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings5,435ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings91ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved76,224ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated484ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG184ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis3,221ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer Service Part BERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments480
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved2,582ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals38ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries4,857ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

Option Year Four

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year FourBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,361,074ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper243,087ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations32,053ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,879ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings48,368ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings173,663ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations10,358ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions833ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions149ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses378ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings366ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries56,520ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries1,041ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,911ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings5,435ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings91ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved77,680ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated492ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG187ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis3,276ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer Service Part BERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments489
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved2,632ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals38ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries4,857ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

Option Year Five

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year FiveBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,362,746ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper243,135ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations32,662ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,915ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings49,286ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings176,962ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations10,555ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions849ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions151ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses385ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings373ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries57,554ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries1,060ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,931ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings5,435ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings91ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved79,102ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated501ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG190ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis3,340ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer Service Part BERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments471
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved2,682ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals39ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries4,857ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

Option Year Six

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year SixBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,364,418ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper243,184ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations33,260ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,950ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings50,188ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings180,201ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations10,748ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions865ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions154ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses392ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings380ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries58,596ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries1,079ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,952ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!
Postpay Complex Reviews0ERROR:#DIV/0!
Medical Review Reopenings5,435ERROR:#DIV/0!
Medical Review Reopenings0ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings91ERROR:#DIV/0!
Defending MR Decisions at ALJ Hearings0ERROR:#DIV/0!
MIP MSP PrepayERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved80,533ERROR:#DIV/0!
Claims Edits Resolved / "I" Records Resolved0ERROR:#DIV/0!
MIP Benefit IntegrityERROR:#DIV/0!
Cases Initiated511ERROR:#DIV/0!
Cases Initiated0ERROR:#DIV/0!
Data Requests - RRB OIG194ERROR:#DIV/0!
Data Requests - RRB OIG0ERROR:#DIV/0!
Data Analysis3,404ERROR:#DIV/0!
Data Analysis0ERROR:#DIV/0!
MIP Provider Customer Service Part BERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
MIP MSP PostpayERROR:#DIV/0!
Duplicate Primary Payments480
Duplicate Primary Payments0ERROR:#DIV/0!
General MSP Inquiries Resolved2,730ERROR:#DIV/0!
General MSP Inquiries Resolved0ERROR:#DIV/0!
Debt Collection and Referrals40ERROR:#DIV/0!
Debt Collection and Referrals0ERROR:#DIV/0!
PM EDIERROR:#DIV/0!
Tier 2 Telephone Inquiries4,857ERROR:#DIV/0!
Tier 2 Telephone Inquiries0ERROR:#DIV/0!

Option Year Seven

RRB SMAC Volume IIRRB SMAC Volume II
Basis of Estimate - Option Year SevenBasis of Estimate - Option Year One
Cost Estimating FactorAnnual
Workload% Workload Processed with Direct LaborPosition/Labor CategoryAnnual Productive
HoursDaily Production per FTETotal FTEs% Workload Processed with Indirect Cost CenterCLIN Template CrosswalkBasis of Estimate
PM Bills/ClaimsERROR:#DIV/0!
Bills Claims - Electronic8,366,091ERROR:#DIV/0!
Bills/Claims - EMC0ERROR:#DIV/0!
Bills Claims - Paper243,233ERROR:#DIV/0!
Bills/Claims - Paper0ERROR:#DIV/0!
PM AppealsERROR:#DIV/0!
Redeterminations33,260ERROR:#DIV/0!
Redeterminations (Claims Cleared)0ERROR:#DIV/0!
QIC Requests Supported1,950ERROR:#DIV/0!
QIC Requests Supported (Case Files Forwarded)0ERROR:#DIV/0!
Clerical Error Reopenings50,188ERROR:#DIV/0!
Clerical Error Reopenings0ERROR:#DIV/0!
Non-Clerical Error Reopenings180,201ERROR:#DIV/0!
Non-Clerical Error Reopenings0ERROR:#DIV/0!
Effectuations of Redeterminations10,748ERROR:#DIV/0!
Effectuations of Redeterminations (Claims)0ERROR:#DIV/0!
Effectuations of QIC Decisions865ERROR:#DIV/0!
Effectuations of QIC Decisions (Claims)0ERROR:#DIV/0!
Effectuations of ALJ Decisions154ERROR:#DIV/0!
Effectuations of ALJ Decisios (Claims)0ERROR:#DIV/0!
PM Beneficiary InquiriesERROR:#DIV/0!
Complex Beneficiary Inquiry Responses392ERROR:#DIV/0!
Complex Beneficiary Inquiry Responses0ERROR:#DIV/0!
Complex 2nd Level Screenings380ERROR:#DIV/0!
Complex 2nd Level Screenings0ERROR:#DIV/0!
Telephone Inquiries58,596ERROR:#DIV/0!
Telephone Inquiries0ERROR:#DIV/0!
Written Inquiries1,079ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
PM Provider EnrollmentERROR:#DIV/0!
Correspondence243,712ERROR:#DIV/0!
Correspondence (includes Revocations and Sanctions, General Correspondence, Manual PTAN Assignment and Online PTAN Assignment)0ERROR:#DIV/0!
Claims102,952ERROR:#DIV/0!
Claims0ERROR:#DIV/0!
PM Provider Customer ServiceERROR:#DIV/0!
Provider Outreach and Education ActivitiesERROR:#DIV/0!
Provider Outreach and Education Activities0ERROR:#DIV/0!
PM Provider InquiriesERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)549,485ERROR:#DIV/0!
Telephone Inquiries (Answered + IVR Handled) (includes General Provider, EDI Tier 1, Telephone Reopening and Provider Enrollment)0ERROR:#DIV/0!
Written Inquiries4,708ERROR:#DIV/0!
Written Inquiries0ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)32ERROR:#DIV/0!
Provider Relations Referral Specialist (PRRS)0ERROR:#DIV/0!
Congressionals11ERROR:#DIV/0!
Congressionals0ERROR:#DIV/0!
Web Portal Transactions3,643,426ERROR:#DIV/0!
Transactions Received0ERROR:#DIV/0!
Web Portal Transactions3,316,744ERROR:#DIV/0!
Transactions Returned0ERROR:#DIV/0!
PM Change ManagementERROR:#DIV/0!
Draft Change Requests422ERROR:#DIV/0!
Draft Change Requests0ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes217ERROR:#DIV/0!
Finalized and Issued Change Requests requiring Shared System Changes0ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes103ERROR:#DIV/0!
Finalized and Issued Change Requests not requiring Shared System Changes0ERROR:#DIV/0!
Technical Direction Letters381ERROR:#DIV/0!
Technical Direction Letters0ERROR:#DIV/0!
Early Involvement Calls85ERROR:#DIV/0!
Early Involvement Calls0ERROR:#DIV/0!
MIP Medical ReviewERROR:#DIV/0!
Routine Manual Medical Reviews1,569ERROR:#DIV/0!
Routine Manual Medical Reviews0ERROR:#DIV/0!
Complex Probe Reviews3,015ERROR:#DIV/0!
Complex Probe Reviews0ERROR:#DIV/0!
Prepay Complex Reviews77,827ERROR:#DIV/0!
Prepay Complex Reviews0ERROR:#DIV/0!
Postpay Complex Reviews3,120ERROR:#DIV/0!

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